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Observational studies raised hopes that vitamin E supplements could help prevent various forms of cancer as well as heart disease . 1 However, observational studies are notoriously unreliable for determining the effectiveness of treatments. Only double-blind trials can do that (for information why, see Why Does This Database Rely on Double-blind Studies? ), and such studies have, on balance, found vitamin E ineffective for preventing heart disease or any common form of cancer other than, possibly, prostate cancer. 2 . In fact, use of high-dose vitamin E for a long period might slightly increasedeath rate. 3 Other potential uses of vitamin E have limited supporting evidence.
Intriguing but far from definitive studies suggest that vitamin E might improve immune response to vaccinations, 4 decrease symptoms of menstrual pain , 5 reduce symptoms of premenstrual syndrome (PMS) , 6 control symptoms of restless legs syndrome , 7 and help prevent deep venous thrombosis (DVTs) . 8 While there is weak evidence that vitamin E supplements can reduce discomfort in rheumatoid arthritis, 9 there is strong evidence that it does not prevent it. 10 Although preliminary studies hinted that use of vitamin E might prevent or slow the progression of cataracts , 11 12 13 in a 10-year study of almost 40,000 female healthcare professionals, use of natural vitamin E at a dose of 600 mg every other day failed to have any effect on cataract development. 14 Evidence regarding whether vitamin E can slow the progression of Alzheimer's disease is inconsistent. 15 A very large study failed to find vitamin E helpful for preventing mental decline (resulting from any cause) in women over 65. 16 Studies of vitamin E in combination with vitamin C for prevention of preeclampsia have yielded inconsistent results. 17 Vitamin E has also shown equivocal promise in diabetes. One double-blind trial found benefits for cardiac autonomic neuropathy , 18 a complication of diabetes. Weaker evidence hints at possible benefits for diabetic peripheral neuropathy . 19 However, the best-designed study of all, a long-term trial involving 3,654 people with diabetes, found that use of vitamin E did not protect against diabetes-induced kidney or heart damage. 20 Similarly, while a few studies performed by one research group suggested that vitamin E might be helpful for improving glucose control in people with diabetes, 21 22 subsequent evidence found that the benefits, if they exist at all, are limited to the short-term. 23 In addition, in an extremely large double-blind study, use of vitamin E at a dose of 600 IU every other day failed to reduce risk of participants developing type 2 diabetes. 202 Finally, a study unexpectedly found that when people with diabetes took 500 mg of vitamin E daily (either as natural alpha tocopherol or a mixture of alpha and gamma tocopherol), their blood pressure increased. 24 Similarly, studies on whether vitamin E is helpful for allergic rhinitis (hay fever) have produced conflicting results. 25 A small double-blind study conducted in Iran reported that vitamin E (400 IU daily) was more effective than placebo for treating menopausal hot flashes . 26 However, a larger US study failed to find vitamin E significantly helpful for hot flashes associated with breast cancer treatment. 27 Vitamin E might help reduce the lung-related side effects caused by the drug amiodarone (used to prevent abnormal heart rhythms). 28 A trial of 108 patients undergoing chemotherapy cisplatin found that vitamin E supplementation (extended 3 months past chemotherapy) reduced cisplatin-related neurotoxicity (damage to nerves not uncommonly occuring with cisplatin). 29 Studies have yielded mixed results on whether vitamin E is helpful for controlling seizures in people with epilepsy , 30 31 32 reducing symptoms of tardive dyskinesia , 33 34 35 36 aiding recovery during heavy exercise , 37 and treating male infertility . 38 When combined with vitamin C , vitamin E may protect against sunburn to a small extent. 39 40 41 42 The same combination has also shown promise for acute anterior uveitis . 43 A separate study failed to find vitamin E alone (at the high dose of 1,600 mg daily) helpful for macular edema (swelling of the center of the retina) associated with uveitis. 44 Vitamin E has been tried for amyotrophic lateral sclerosis (Lou Gehrig's disease), but the results in the first reported double-blind study showed questionable benefits if any. 45 Some vitamin E proponents felt that the dose of vitamin E used in this study might have been too low. Accordingly, they conducted another study using 10 timesthe dose, this one lasting 18 months and enrolling 160 people. 46 Once again, vitamin E failed to prove significantly more effective than placebo.
In one observational study, high intake of vitamin E was linked to decreased risk of progression to AIDS in people with HIV infection. 47 However, a double-blind study of 49 people with HIV who took combined vitamins C and E or placebo for 3 months did not show any significant effects on the amount of HIV virus detected or the number of opportunistic infections. 48 It has been suggested that vitamin E may enhance the antiviral effects of AZT, but evidence for this is minimal. 49 Vitamin E has been suggested for preventing the cardiac toxicity caused by the drug doxorubicin . However, while it has shown promise in animal studies, when studied in people vitamin E has persistently failed to prove effective for this purpose. 50 51 52 Vitamin E is sometimes recommended for osteoarthritis . However, a 2-year, double-blind, placebo-controlled study of 136 people with osteoarthritis of the knee failed to find any benefit in terms of symptom control or slowing disease progression. 53 A previous 6-month, double-blind, placebo-controlled trial of 77 individuals with osteoarthritis also failed to find benefit. 54 A 4-year, double-blind, placebo-controlled trial of 1,193 people with macular degeneration failed to find vitamin E alone helpful for preventing or treating macular degeneration. 55 Vitamin E has also so far failed to prove helpful for preventing or treating alcoholic hepatitis , 56 asthma , 57 congestive heart failure , 58 fibrocystic breast disease , 59 or Parkinson's disease . 60 61 In a very large study involving over 29,000 male smokers, researchers failed to find benefit of alpha-tocopherol (50 IU/day), beta-carotene (20 mg/day), or the two taken together for the prevention of type 2 diabetes over 5-8 year period. 62
- Helzlsouer KJ, Huang HY, Alberg AJ, Hoffman S, Burke A, Norkus EP, Morris JS, Comstock GW. Association between alpha-tocopherol, gamma-tocopherol, selenium, and subsequent prostate cancer. J Natl Cancer Inst. 92(24):2018-23.
- Törnwall ME, Virtamo J, Haukka JK, Aro A, Albanes D, Huttunen JK. The effect of alpha-tocopherol and beta-carotene supplementation on symptoms and progression of intermittent claudication in a controlled trial. Atherosclerosis. 147(1):193-7.
- Miller ER 3rd, Pastor-Barriuso R, Dalal D, Riemersma RA, Appel LJ, Guallar E. Meta-analysis: high-dosage vitamin E supplementation may increase all-cause mortality. Ann Intern Med. 142(1):37-46.
- Meydani SN, Meydani M, Blumberg JB, Leka LS, Siber G, Loszewski R, Thompson C, Pedrosa MC, Diamond RD, Stollar BD. Vitamin E supplementation and in vivo immune response in healthy elderly subjects. A randomized controlled trial. JAMA. 277(17):1380-6.
- Ziaei S, Faghihzadeh S, Sohrabvand F, Lamyian M, Emamgholy T. A randomised placebo-controlled trial to determine the effect of vitamin E in treatment of primary dysmenorrhoea. BJOG. 108(11):1181-3.
- London RS, Murphy L, Kitlowski KE, Reynolds MA. Efficacy of alpha-tocopherol in the treatment of the premenstrual syndrome. J Reprod Med. 32(6):400-4.
- Ayres S, Mihan R. Restless legs syndrome: response to vitamin E. J Appl Nutr. 1973;25:8-15.
- Glynn RJ, Ridker PM, Goldhaber SZ, Zee RY, Buring JE. Effects of random allocation to vitamin E supplementation on the occurrence of venous thromboembolism: report from the Women's Health Study. Circulation. 116(13):1497-503.
- Edmonds SE, Winyard PG, Guo R, Kidd B, Merry P, Langrish-Smith A, Hansen C, Ramm S, Blake DR. Putative analgesic activity of repeated oral doses of vitamin E in the treatment of rheumatoid arthritis. Results of a prospective placebo controlled double blind trial. Ann Rheum Dis. 56(11):649-55.
- Karlson EW, Shadick NA, Cook NR, Buring JE, Lee IM. Vitamin E in the primary prevention of rheumatoid arthritis: the Women's Health Study. Arthritis Rheum. 59(11):1589-95.
- Tavani A, Negri E, La Vecchia C. Food and nutrient intake and risk of cataract. Ann Epidemiol. 6(1):41-6.
- Leske MC, Chylack LT Jr, He Q, Wu SY, Schoenfeld E, Friend J, Wolfe J. Antioxidant vitamins and nuclear opacities: the longitudinal study of cataract. Ophthalmology. 105(5):831-6.
- Teikari JM, Rautalahti M, Haukka J, Järvinen P, Hartman AM, Virtamo J, Albanes D, Heinonen O. Incidence of cataract operations in Finnish male smokers unaffected by alpha tocopherol or beta carotene supplements. J Epidemiol Community Health. 52(7):468-72.
- Christen WG, Glynn RJ, Chew EY, Buring JE. Vitamin E and age-related cataract in a randomized trial of women. Ophthalmology. 115(5):822-829.e1.
- Sano M, Ernesto C, Thomas RG, et al. A controlled trial of selegiline, alpha-tocopherol, or both as treatment for Alzheimer's disease. N Engl J Med. 1997;336:1216-1222.
- Kang JH, Cook N, Manson J, et al. A randomized trial of vitamin E supplementation and cognitive function in women. Arch Intern Med, 2006;166:2462-2468.
- Chappell LC, Seed PT, Briley AL, Kelly FJ, Lee R, Hunt BJ, Parmar K, Bewley SJ, Shennan AH, Steer PJ, Poston L. Effect of antioxidants on the occurrence of pre-eclampsia in women at increased risk: a randomised trial. Lancet. 354(9181):810-6.
- Manzella D, Barbieri M, Ragno E, Paolisso G. Chronic administration of pharmacologic doses of vitamin E improves the cardiac autonomic nervous system in patients with type 2 diabetes. Am J Clin Nutr. 73(6):1052-7.
- Tutuncu NB, Baraktar M, Varli K. Reversal of defective nerve conduction with vitamin E supplementation in type 2 diabetes. Diabetes Care. 1998;21:1915-1918.
- Lonn E, Yusuf S, Hoogwerf B, Pogue J, Yi Q, Zinman B, Bosch J, Dagenais G, Mann JF, Gerstein HC, HOPE Study, MICRO-HOPE Study. Effects of vitamin E on cardiovascular and microvascular outcomes in high-risk patients with diabetes: results of the HOPE study and MICRO-HOPE substudy. Diabetes Care. 25(11):1919-27.
- Paolisso G, D'Amore A, Galzerano D, et al. Daily vitamin E supplements improve metabolic control but not insulin secretion in elderly type II diabetic patients. Diabetes Care. 1993;16:1433-1437.
- Paolisso G, Di Maro G, Galzerano D, Cacciapuoti F, Varricchio G, Varricchio M, D'Onofrio F. Pharmacological doses of vitamin E and insulin action in elderly subjects. Am J Clin Nutr. 59(6):1291-6.
- Manning PJ, Sutherland WH, Walker RJ, Williams SM, De Jong SA, Ryalls AR, Berry EA. Effect of high-dose vitamin E on insulin resistance and associated parameters in overweight subjects. Diabetes Care. 27(9):2166-71.
- Ward NC, Wu JH, Clarke MW, Puddey IB, Burke V, Croft KD, Hodgson JM. The effect of vitamin E on blood pressure in individuals with type 2 diabetes: a randomized, double-blind, placebo-controlled trial. J Hypertens. 25(1):227-34.
- Shahar E, Hassoun G, Pollack S. Effect of vitamin E supplementation on the regular treatment of seasonal allergic rhinitis. Ann Allergy Asthma Immunol. 92(6):654-8.
- Ziaei S, Kazemnejad A, Zareai M. The effect of vitamin E on hot flashes in menopausal women. Gynecol Obstet Invest. 64(4):204-7.
- Barton DL, Loprinzi CL, Quella SK, Sloan JA, Veeder MH, Egner JR, Fidler P, Stella PJ, Swan DK, Vaught NL, Novotny P. Prospective evaluation of vitamin E for hot flashes in breast cancer survivors. J Clin Oncol. 16(2):495-500.
- Kachel DL, Moyer TP, Martin WJ II. Amiodarone-induced injury of human pulmonary artery endothelial cells: protection by alpha-tocopherol. J Pharmacol Exp Ther. 1990;254:1107-1112.
- Pace A, Giannarelli D, Galiè E, Savarese A, Carpano S, Della Giulia M, Pozzi A, Silvani A, Gaviani P, Scaioli V, Jandolo B, Bove L, Cognetti F. Vitamin E neuroprotection for cisplatin neuropathy: a randomized, placebo-controlled trial. Neurology. 74(9):762-6.
- Ogunmekan AO, Hwang PA. A randomized, double-blind, placebo-controlled, clinical trial of D-alpha-tocopheryl acetate (vitamin E), as add-on therapy, for epilepsy in children. Epilepsia. 30(1):84-9.
- Raju GB, Behari M, Prasad K, Ahuja GK. Randomized, double-blind, placebo-controlled, clinical trial of D-alpha-tocopherol (vitamin E) as add-on therapy in uncontrolled epilepsy. Epilepsia. 35(2):368-72.
- Levy SL, Burnham WM, Bishai A, Hwang PA. The anticonvulsant effects of vitamin E: a further evaluation. Can J Neurol Sci. 19(2):201-3.
- Adler LA, Edson R, Lavori P, Peselow E, Duncan E, Rosenthal M, Rotrosen J. Long-term treatment effects of vitamin E for tardive dyskinesia. Biol Psychiatry. 43(12):868-72.
- Lohr JB, Caligiuri MP. A double-blind placebo-controlled study of vitamin E treatment of tardive dyskinesia. J Clin Psychiatry. 57(4):167-73.
- Rotrosen J, Adler L, Lohr J, Edson R, Lavori P. Antioxidant treatment of tardive dyskinesia. Prostaglandins Leukot Essent Fatty Acids. 55(1-2):77-81.
- Adler LA, Peselow E, Rotrosen J, Duncan E, Lee M, Rosenthal M, Angrist B. Vitamin E treatment of tardive dyskinesia. Am J Psychiatry. 150(9):1405-7.
- McBride JM, Kraemer WJ, Triplett-McBride T, Sebastianelli W. Effect of resistance exercise on free radical production. Med Sci Sports Exerc. 30(1):67-72.
- Suleiman SA, Ali ME, Zaki ZM, el-Malik EM, Nasr MA. Lipid peroxidation and human sperm motility: protective role of vitamin E. J Androl. 17(5):530-7.
- Fuchs J, Kern H. Modulation of UV-light-induced skin inflammation by D-alpha-tocopherol and L-ascorbic acid: a clinical study using solar simulated radiation. Free Radic Biol Med. 25(9):1006-12.
- Eberlein-König B, Placzek M, Przybilla B. Protective effect against sunburn of combined systemic ascorbic acid (vitamin C) and d-alpha-tocopherol (vitamin E). J Am Acad Dermatol. 38(1):45-8.
- Darr D, Dunston S, Faust H, et al. Effectiveness of antioxidants (vitamin C and E) with and without sunscreens as topical photoprotectants. Acta Derm Venereol. 1996;76:264-268.
- Trevithick JR, Shum DT, Redae S, Mitton KP, Norley C, Karlik SJ, Groom AC, Schmidt EE. Reduction of sunburn damage to skin by topical application of vitamin E acetate following exposure to ultraviolet B radiation: effect of delaying application or of reducing concentration of vitamin E acetate applied. Scanning Microsc. 7(4):1269-81.
- van Rooij J, Schwartzenberg SGWS, Mulder PGH, et al. Oral vitamins C and E as additional treatment in patients with acute anterior uveitis: a randomised double masked study in 145 patients. Br J Ophthalmol. 1999;83:1277-1282.
- Nussenblatt RB, Kim J, Thompson DJ, Davis MD, Chew E, Ferris FL, Buggage R. Vitamin E in the treatment of uveitis-associated macular edema. Am J Ophthalmol. 141(1):193-4.
- Desnuelle C, Dib M, Garrel C, et al. A double-blind, placebo-controlled randomized clinical trial of alpha-tocopherol (vitamin E) in the treatment of amyotrophic lateral sclerosis. ALS riluzole-tocopherol Study Group. Amyotroph Lateral Scler Other Motor Neuron Disord. 2001;2:9-18.
- Graf M, Ecker D, Horowski R, Kramer B, Riederer P, Gerlach M, Hager C, Ludolph AC, Becker G, Osterhage J, Jost WH, Schrank B, Stein C, Kostopulos P, Lubik S, Wekwerth K, Dengler R, Troeger M, Wuerz A, Hoge A, Schrader C, Schimke N, Krampfl K, Petri S, Zierz S, Eger K, Neudecker S, Traufeller K, Sievert M, Neundörfer B, Hecht M, German vitamin E/ALS Study Group. High dose vitamin E therapy in amyotrophic lateral sclerosis as add-on therapy to riluzole: results of a placebo-controlled double-blind study. J Neural Transm. 112(5):649-60.
- Abrams B, Duncan D, Hertz-Picciotto I. A prospective study of dietary intake and acquired immune deficiency syndrome in HIV-seropositive homosexual men. J Acquir Immune Defic Syndr. 6(8):949-58.
- Allard JP, Aghdassi E, Chau J, Tam C, Kovacs CM, Salit IE, Walmsley SL. Effects of vitamin E and C supplementation on oxidative stress and viral load in HIV-infected subjects. AIDS. 12(13):1653-9.
- Gogu SR, Beckman BS, Rangan SR, Agrawal KC. Increased therapeutic efficacy of zidovudine in combination with vitamin E. Biochem Biophys Res Commun. 165(1):401-7.
- Puri A, Maulik SK, Ray R, Bhatnagar V. Electrocardiographic and biochemical evidence for the cardioprotective effect of vitamin E in doxorubicin-induced acute cardiotoxicity in rats. Eur J Pediatr Surg. 15(6):387-91.
- Berthiaume JM, Oliveira PJ, Fariss MW, Wallace KB. Dietary vitamin E decreases doxorubicin-induced oxidative stress without preventing mitochondrial dysfunction. Cardiovasc Toxicol. 5(3):257-67.
- Wahab MH, Akoul ES, Abdel-Aziz AA. Modulatory effects of melatonin and vitamin E on doxorubicin-induced cardiotoxicity in Ehrlich ascites carcinoma-bearing mice. Tumor. 2000;86:157-162.
- Wluka AE, Stuckey S, Brand C, et al. Supplementary vitamin E does not affect the loss of cartilage volume in knee osteoarthritis: a 2 year double blind randomized placebo controlled study. J Rheumatol. 2002;29:2585-2591.
- Brand C, Snaddon J, Bailey M, Cicuttini F. Vitamin E is ineffective for symptomatic relief of knee osteoarthritis: a six month double blind, randomised, placebo controlled study. Ann Rheum Dis. 60(10):946-9.
- Taylor HR, Tikellis G, Robman LD, McCarty CA, McNeil JJ. Vitamin E supplementation and macular degeneration: randomised controlled trial. BMJ. 325(7354):11.
- Mezey E, Potter JJ, Rennie-Tankersley L, Caballeria J, Pares A. A randomized placebo controlled trial of vitamin E for alcoholic hepatitis. J Hepatol. 40(1):40-6.
- Pearson PJ, Lewis SA, Britton J, Fogarty A. Vitamin E supplements in asthma: a parallel group randomised placebo controlled trial. Thorax. 59(8):652-6.
- Keith ME, Jeejeebhoy KN, Langer A, Kurian R, Barr A, O'Kelly B, Sole MJ. A controlled clinical trial of vitamin E supplementation in patients with congestive heart failure. Am J Clin Nutr. 73(2):219-24.
- London RS, Sundaram GS, Murphy L, Manimekalai S, Reynolds M, Goldstein PJ. The effect of vitamin E on mammary dysplasia: a double-blind study. Obstet Gynecol. 65(1):104-6.
- The Parkinson Study Group. Effects of tocopherol and deprenyl on the progression of disability in early Parkinson's disease. New Engl J Med. 1993;97:176-183.
- Kieburtz K, McDermott M, Como P, et al. The effect of deprenyl and tocopherol on cognitive performance in early untreated Parkinson's disease. Parkinson Study Group. Neurology. 1994;44:1756-1759.
- Kataja-Tuomola M, Sundell JR, Männistö S, Virtanen MJ, Kontto J, Albanes D, Virtamo J. Effect of alpha-tocopherol and beta-carotene supplementation on the incidence of type 2 diabetes. Diabetologia. 51(1):47-53.